Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
  • A61F2/16—Intraocular lenses
  • A61F2/1613—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus
  • A61F2/1616—Pseudo-accommodative, e.g. multifocal or enabling monovision
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
  • A61F2/16—Intraocular lenses
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
• • B—PERFORMING OPERATIONS; TRANSPORTING
  • B29—WORKING OF PLASTICS; WORKING OF SUBSTANCES IN A PLASTIC STATE IN GENERAL
  • B29D—PRODUCING PARTICULAR ARTICLES FROM PLASTICS OR FROM SUBSTANCES IN A PLASTIC STATE
  • B29D11/00—Producing optical elements, e.g. lenses or prisms
• • B—PERFORMING OPERATIONS; TRANSPORTING
  • B29—WORKING OF PLASTICS; WORKING OF SUBSTANCES IN A PLASTIC STATE IN GENERAL
  • B29D—PRODUCING PARTICULAR ARTICLES FROM PLASTICS OR FROM SUBSTANCES IN A PLASTIC STATE
  • B29D11/00—Producing optical elements, e.g. lenses or prisms
  • B29D11/00932—Combined cutting and grinding thereof
  • B29D11/00942—Combined cutting and grinding thereof where the lens material is mounted in a support for mounting onto a cutting device, e.g. a lathe, and where the support is of machinable material, e.g. plastics
• • B—PERFORMING OPERATIONS; TRANSPORTING
  • B29—WORKING OF PLASTICS; WORKING OF SUBSTANCES IN A PLASTIC STATE IN GENERAL
  • B29D—PRODUCING PARTICULAR ARTICLES FROM PLASTICS OR FROM SUBSTANCES IN A PLASTIC STATE
  • B29D11/00—Producing optical elements, e.g. lenses or prisms
  • B29D11/02—Artificial eyes from organic plastic material
  • B29D11/023—Implants for natural eyes
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
  • A61F2/16—Intraocular lenses
  • A61F2/1613—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/0077—Special surfaces of prostheses, e.g. for improving ingrowth
  • A61F2002/009—Special surfaces of prostheses, e.g. for improving ingrowth for hindering or preventing attachment of biological tissue
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
  • A61F2/16—Intraocular lenses
  • A61F2002/1681—Intraocular lenses having supporting structure for lens, e.g. haptics
  • A61F2002/1689—Intraocular lenses having supporting structure for lens, e.g. haptics having plate-haptics
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
  • A61F2/16—Intraocular lenses
  • A61F2002/16965—Lens includes ultraviolet absorber
  • A61F2002/1699—Additional features not otherwise provided for

Definitions

• the present invention relates to intraocular lenses (IOLs) for implantation in an aphakic eye where the natural lens has been removed due to damage or disease (e.g., a cataractous lens).
• IOLs intraocular lenses
• the present invention more particularly relates to a novel IOL designed in a first aspect to be inserted through a sub-3mm incision made in the eye, and in a second aspect includes a sharp posterior edge to inhibit unwanted growth of lens epithelial cells (hereinafter "LECs”) between the IOL and posterior capsular bag, also known as posterior capsule opacification (hereinafter "PCO").
• LECs lens epithelial cells
• a common and desirable method of treating a cataract eye is to remove the clouded, natural lens and replace it with an artificial IOL in a surgical procedure known as cataract extraction, hi the extracapsular extraction method, the natural lens is removed from the capsular bag while leaving the posterior part of the capsular bag (and preferably at least part of the anterior part of the capsular bag) in place within the eye. hi this instance, the capsular bag remains anchored to the eye's ciliary body through the zonular fibers.
• intracapsular extraction both the lens and capsular bag are removed in their entirety by severing the zonular fibers and replaced with an IOL which must be anchored within the eye absent the capsular bag.
• the intracapsular extraction method is considered less attractive as compared to the extracapsular extraction method since in the extracapsular method, the capsular bag remains attached to the eye's ciliary body and thus provides a natural centering and locating means for the IOL within the eye.
• the capsular bag also continues its function of providing a natural barrier between the aqueous humor at the front of the eye and the vitreous humor at the rear of the eye.
• posterior capsule opacification or secondary cataract
• proliferation and migration of lens epithelial cells occur along the posterior capsule behind the IOL posterior surface which creates an opacification of the capsule along the optical axis.
• Undesirable complications may follow the capsulotomy.
• the posterior capsule provides a natural barrier between the back of the eye vitreous humor and front of the eye aqueous humor
• removal of the posterior capsule allows the vitreous humor to migrate into the aqueous humor which can result in serious, sight- threatening complications. It is therefore highly desirable to prevent posterior capsule opacification in the first place and thereby obviate the need for a subsequent posterior capsulotomy.
• One method for preventing PCO is to create a sharp, discontinuous bend in the posterior capsule wall which is widely recognized by those skilled in the art as an effective method for minimizing PCO. See, for example, Posterior Capsule Opacification by Nishi, Journal of Cataract & Refractive Surgery, Vol. 25, Jan. 1999.
• This discontinuous bend in the posterior capsule wall can be created using an IOL having a sharp posterior edge.
• Another PCO prevention method uses an LEC-targeted pharmaceutical agent. See, for example, U.S. Patent 5,620,013 to Bretton entitled “Method For Destroying Residual Lens Epithelial Cells". While this approach is logical in theory, putting such a method into clinical practice is difficult due to complications arising, for example, from the toxicity of some of the LEC inhibiting agents themselves (e.g., saporin), as well as the difficulty in ensuring a total kill of all LECs in the capsular bag. Any remaining LECs may eventually multiply and migrate over the IOL, eventually resulting in PCO despite the attempt at LEC removal at the time of surgery.
• LEC inhibiting agents themselves (e.g., saporin)
• Any remaining LECs may eventually multiply and migrate over the IOL, eventually resulting in PCO despite the attempt at LEC removal at the time of surgery.
• the most promising method for inhibiting LEC formation on the posterior surface of an IOL is by designing the IOL to have a sharp peripheral edge particularly at the posterior surface to create a discontinuous bend in the posterior capsule wall.
• This discontinuous bend in the posterior capsule wall has been clinically proven to inhibit the growth and migration of LECs past this bend and along the IOL surface.
• IOLs and IOL injectors capable of successfully injecting the IOL through a sub 3-mm incision is desirable to most present-day cataract surgeons. Since the IOL must undergo compression and other forces as it is passed through the IOL injector and injected into the eye, the dimensions (particularly the cross-section) of the IOL must accordingly be minimized. An IOL designer is thus further challenged in making an IOL which on the one hand will have the strength and stability to remain centered in the eye, and on the other hand have small enough dimensions to pass through a sub-3mm injector and into the eye.
• the present invention addresses the problem of PCO formation by providing an IOL having an optic periphery including a sharp edge that contacts the posterior capsular bag wall when the IOL is implanted in the eye.
• the present invention provides an IOL designed with dimensions small enough to enable it to be compressed and injected through a sub-3mm incision made in an eye, yet also remains stably positioned in the eye.
• the anti-PCO sharp edge is defined by two surfaces forming an acute angle located between a posterior concave region and an outer-most peripheral edge that extends parallel to the optical axis.
• the sharp edge extends 360° around the posterior optic surface to form a complete barrier to LECs attempting to migrate radially inwardly to the posterior optic surface.
• an anterior concave region is formed between the anterior optic surface and an optional peripheral edge surface that extends perpendicular to the optical axis and intersects at a 90° angle with the peripheral edge surface that extends parallel to the optical axis.
• the posterior and anterior concave regions are preferably located opposite each other and are of substantially the same radius.
• the one or more haptics which help stabilize the IOL in the eye are preferably spaced from the posterior limit of the outer-most posterior edge surface.
• the IOL optic is thus reduced in size through the anterior and posterior concave regions yet strength and stability of the IOL is maintained. This is due at least in part to the haptic thickness which has not been reduced compared to prior art IOLs of similar design (see Fig. 6 where the prior art IOL is shown in dotted lines compared to the inventive IOL which is shown in solid lines).
• the anterior concave region increases the in-situ stability of the IOL by preventing the IOL from vaulting anteriorly (i.e., toward the cornea) and thereby also helps keep the sharp edge firmly indented into the posterior capsular bag wall.
• the sharp edge also provides additional material area to the posterior side as compared to the anterior side which balances the posterior concave region in that the IOL will vault posteriorly despite the posterior concave region which, as stated above, reduces the overall dimension of the optic to allow it to be passed through a sub-3mmm incision.
• the anterior concave region acts to urge the IOL to vault posteriorly
• the posterior concave region does not urge the IOL to vault anteriorly due to the extra material on the posterior side attributed by the posterior sharp edge.
• the spacing of the haptic from the posterior limit of the outer-most posterior edge also assists in maintaining the posterior vault.
• the present IOL has a peripheral edge design which is relatively easy to manufacture compared with other, more complicated IOL periphery designs which have been proposed in the prior art for inhibiting LEC migration.
• some prior art IOLs have square edges that may require an additional processing (e.g. milling) step to form the square edge geometry. See, for example, the following patents which show various IOL optic periphery designs:
• the IOL of the present invention is made of a lathable IOL material such as an intraocular grade acrylic, for example.
• a button of the lens material is blocked to an arbor and a first side thereof is lathed to form a first surface of the optic and haptics as a single piece. The button is removed from the arbor, flipped over and blocked to the same or another arbor for lathing of the second surface of the optic and haptics.
• the lathing of the first surface forms the square edge which extends 360° about the entire optic. No other operation is required to form the square edge.
• the button is transferred to a milling station where the finished perimeter of the one-piece IOL including the haptics and optic is milled.
• the IOL is then removed from the arbor and undergoes further processing as necessary (e.g., hydration, polishing, inspection, power assignment and packaging).
• Figure 1 is a cross-sectional view of a human eye showing the natural lens within the capsular bag of the eye;
• Figure 2 is a cross-sectional view of a human eye showing the natural lens removed and replaced with a prior art IOL;
• Figure 3 is a perspective view of an embodiment of the inventive IOL with the posterior optic surface thereof facing upwardly;
• Figure 4 is a cross-sectional view of the IOL as taken generally along the line 4-4 of Figure 3;
• Figure 5 is an enlarged cross-sectional view of Fig. 6 showing half the IOL to illustrate the edge detail
• Figure 6 is a cross-sectional view comparing a prior art IOL in dotted lines to the inventive IOL in solid lines as taken generally along the line 6-6 of Figure 3.
• Figure 1 a cross-sectional view of a human eye 10 having an anterior chamber 12 and a posterior chamber 14 separated by the iris 30.
• a capsule 16 which holds the eye's natural crystalline lens 17.
• the retina connects to the optic nerve 22 which transmits the image received by the retina to the brain for interpretation of the image.
• the natural lens In an eye where the natural crystalline lens has been damaged (e.g., clouded by cataracts), the natural lens is no longer able to properly focus and direct incoming light to the retina and images become blurred.
• a well known surgical technique to remedy this situation involves removal of the damaged crystalline lens which may be replaced with an artificial lens known as an intraocular lens or IOL such as prior art IOL 24 seen in Figure 2.
• IOL intraocular lens
• the present invention concerns itself with an IOL for implanting inside the substantially ovoid-shaped capsule 16 of eye 10.
• This implantation technique is commonly referred to in the art as the "in-the-bag” technique.
• a part of the anterior portion of the capsular bag is cut away (termed a "capsularhexis") while leaving the posterior capsule 16a intact and still secured to the ciliary body 26.
• the IOL is placed inside the capsule 16 which is located behind the iris 30 in the posterior chamber 14 of the eye.
• An IOL includes a central optic portion 24a which simulates the extracted natural lens by directing and focusing light upon the retina, and further includes a means for securing the optic in proper position within the capsular bag.
• a common IOL structure for securing the optic is called a haptic which is a resilient structure extending radially outwardly from the periphery of the optic.
• two haptics 24b, 24c extend from opposite sides of the optic and curve to provide a biasing force against the inside of the capsule which secures the optic in the proper position within the capsule.
• an undesirable post-surgical condition known as posterior capsule opacification or PCO may occur which results in an implanted IOL becoming clouded and thus no longer able to properly direct and focus light therethrough.
• the main cause for this condition is the mitosis and migration of lens epithelial cells (LECs) across the posterior surface of the capsule behind the IOL optic.
• LECs lens epithelial cells
• the posterior surface 16a of the capsule 16 touches the posterior surface of the IOL optic 24a.
• IOL 32 is seen to include a central optic portion 34 having opposite anterior and posterior surfaces 34a and 34b, respectively.
• anterior optic surface 34a faces the cornea 18
• posterior optic surface 34b faces the retina 20.
• a total of four haptics 36-39 are attached to and extend from optic portion 34 and are configured to provide a biasing force against the interior of the capsule 16 to properly position IOL 32 therein.
• the haptics 36-39 are configured such that upon implanting the IOL with the capsular bag, the haptics engage the interior surface of the capsular bag. The engagement between the haptics and capsule creates a biasing force causing the IOL optic 34 to vault posteriorly toward the retina 20 whereupon the posterior surface 34b of the IOL optic presses tightly against the interior of the posterior capsule wall 16a of capsule 16.
• IOL 32 may be made from any suitable IOL material, e.g., PMMA, silicone, acrylics, hydrogels, and combinations thereof.
• the IOL 32 may also be a one piece (e.g., where the optics and haptics are formed from a single piece of material) or multiple piece design (e.g. where the haptics are attached to the optic after the optic is formed).
• the IOL is lathed as a single piece from a button of intraocular grade acrylic as discussed more fully below.
• IOL optic 34 has a periphery including a posteriorly facing sharp edge 40 which is effective for inhibiting PCO by creating a bend in the posterior capsule wall when the IOL 32 is implanted in the eye capsule as explained above.
• Sharp edge 40 is defined at the apex of angle "A" which, in turn, is defined by first and second surfaces 40a, 40b.
• Angle "A” is preferably between about 70 and 120 degrees, is more preferably between about 80 and 100 degrees, and most preferably is about 90 degrees.
• the apex of sharp edge 40 lies along an apex axis AA which extends substantially parallel to the optical axis OA.
• First surface 40a smoothly blends into a posterior concave region 42 which, in turn, smoothly blends into the posterior optic surface 34b.
• the posterior optic surface 34b of course contributes to the patient's vision and may be of any desired optical design including, for example, spherical, aspherical, tone, multifocal, accommodating (including the dual optic type), and combinations thereof.
• the periphery of the optic posterior surface 34b begins where the posterior concave region 42 begins to straighten as it extends radially inwardly, this area being designated 50p in Fig. 5.
• the second sharp edge surface 40b intersects the outer-most peripheral edge surface 44 and together therewith forms an obtuse angle "B" which is preferably between about 110 and 150 degrees, is more preferably between about 120 and 140 degrees, and most preferably is about 130 degrees.
• Outer-most peripheral edge surface 44 is thus located radially outwardly of sharp edge 40 and extends substantially parallel to the optical axis OA and thus also apex axis AA.
• One or more haptics such as haptics 36-39 extend from the outer-most peripheral edge surface 44 to properly locate the IOL optic 34 in the capsular bag of the patient's eye.
• haptic thickness Ti is preferably between about 0.20mm and 0.40mm, is more preferably between about 0.25mm and 0.35mm, and is most preferably about 0.30mm.
• Haptic thickness T 1 is less than the thickness T 2 of the outer-most peripheral edge surface 44 which is preferably between about 0.25mm and 0.50mm, is more preferably between about 0.30mm and 0.40mm, and is most preferably about 0.37mm.
• the haptics are also preferably spaced from the posterior limit 44p of the outer-most peripheral edge 44, i.e. the intersection of surface 40b and peripheral edge surface 44.
• the height H 1 of the PCO barrier created by sharp posterior edge 40 as measured from the apex thereof to the haptic is preferably between about 0.05mm and 0.25mm, is more preferably between about 0.10mm and 0.20mm, and is most preferably about 0.13mm.
• an anterior concave region 46 is provided on the anterior surface of the IOL. This anterior concave region 46 is located radially outwardly of and smoothly blends with the anterior optic surface 34a at or near their meeting point 50a. Anterior concave region 46 extends radially outwardly and intersects anterior peripheral edge surface 48 in the opposite direction to form an obtuse angle "D" therewith.
• Anterior peripheral edge surface 48 extends substantially perpendicular to the optical axis OA and forms a substantially right angle "C" with outer-most peripheral edge surface 44 at one end, and an obtuse angle “D” with the anterior concave peripheral region 46 at the other end thereof.
• Angle "D” is preferably between about 120 and 160 degrees, is more preferably between about 130 and 150 degrees, and is most preferably about 140 degrees.
• anterior peripheral edge surface 48 is optional and in an alternate embodiment, anterior concave region 46 extends along dotted line 51 in Fig. 5 and directly intersects and forms an acute angle with outer-most peripheral edge surface 44.
• the anterior and posterior optic surfaces 34a, 34b are both convex.
• the dimensions provided above are suited for an IOL across a power range of about 1OD to about 3OD. It is noted, however, that the invention is not limited to a bi-convex optic or a particular power.
• IOL 32 is formed from acrylic and is lathed and milled in one piece from an intraocular grade acrylic button.
• an acrylic button is blocked (mounted) to an arbor which in turn is mounted to a lathe having a cutting tool (preferably a diamond cutting tool).
• the arbor is set rotating while the cutting tool lathes what will become the posterior optic surface 34b including the sharp edge 40, the posterior concave region 42, and the posterior facing surfaces of haptics 36- 39.
• the arbor is removed from the lathe and the button is deblocked (removed) from the arbor.
• the button is flipped over and blocked to another arbor (posterior face down).
• the arbor is mounted to the lathe and set rotating while the cutting tool lathes what will become the anterior surface 34a of the optic, the anterior concave region 46, the optional anterior edge surface 48, and the anterior facing surfaces of haptics 36-39.
• the arbor is removed from the lathe and transferred to a milling machine.
• the arbor remains stationary while the milling tool cuts a path entirely through the button to form the complete perimeter P (outline) of the one-piece IOL (see Fig. 3).
• the milling operation also cuts out the holes 36'-39' in the haptics 36-39.
• the center thickness CT of the inventive IOL 32 is smaller than the center thickness CT' of the prior art IOL 32', the anterior and posterior concave regions 46 and 42 have reduced the area at the periphery of the optic, and the sharp edge 40 has been formed.
• the CT of the inventive IOL 32 is between about 0.50mm for a +10.00 D (diopter) lens and about 1.1mm for a +30.00 D lens.
• the prior art IOL 32' is not able to pass through a sub-3mm incision nor does it have any feature to inhibit or prevent PCO.
• the minimum thickness between R 1 and R 2 is designated T 3 and this is preferably between about 0.10mm and 0.3mm and is most preferably about 0.20mm.
• the one or more haptics 36-39 which help stabilize the IOL in the eye are preferably spaced from the posterior limit 44p of the outer-most posterior edge surface 44.
• the IOL optic 34 is this reduced in size through the anterior and posterior concave regions 46 and 42 yet strength and stability of the IOL 32 is maintained.
• the optic thickness T 3 as measured between the anterior and posterior concave regions 46, 42 is less than the haptic thickness T 1 .
• the anterior concave region 46 increases the in-situ stability of the IOL by preventing the IOL from vaulting anteriorly (i.e., toward the cornea) and thereby also helps keep the sharp edge 40 firmly indented into the posterior capsular bag wall. This creates a barrier to inward migration of LECs and PCO is thereby inhibited.
• the sharp edge 40 also provides additional material area to the posterior side of the IOL as compared to the anterior side of the IOL which balances the posterior concave region 42 in that the IOL will vault posteriorly despite the posterior concave region 42 which, as stated above, reduces the overall dimension of the optic 34 to allow it to be passed through a sub-3mmm incision.
• the anterior concave region 46 acts to urge the IOL to vault posteriorly
• the posterior concave region 42 does not urge the IOL to vault anteriorly due to the extra material on the posterior side attributed by the posterior sharp edge 40.
• the spacing of the haptic 36-39 from the posterior limit 44p of the outer-most posterior edge 44 also assists in maintaining the posterior vault.
• the optic thickness T 3 as measured between the anterior and posterior concave regions 46, 42 is less than the haptic thickness T 1 (see values given above) which also contributes to the strength and stability of the IOL in-situ.

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